Plastic surgery does not begin when the patient walks into the operating room. Before that, there is a fundamental step: the consultation, in which it is assessed whether the procedure is appropriate for the person, the risks are explained, expectations are discussed, and the conditions under which the procedure will be performed are defined.
“What result can I expect?”, “When will I be able to return to work?”, “Will the scar be noticeable?”. These are common questions in a plastic surgery consultation. And they are important. But before reaching them there are other questions that should also be part of the conversation: Is this surgery right for me?, what alternatives exist?, what risks does it entail?, who will perform it?, where will it be done and what will the recovery be like?
The American Society of Plastic Surgeons (ASPS) proposes a question guide for patients that includes precisely these aspects: whether the person is a good candidate for the procedure, the surgeon’s training and experience, where and how the intervention will be performed, how long recovery may last, what the risks and complications are, how they are managed, and what outcomes are reasonable. The organization also notes that open communication between patient and surgeon, combined with an understanding of the goals, expectations and motivations, helps determine whether plastic surgery is the right option.
From my perspective as a surgeon, the consultation should not be reduced to showing a photograph and talking about how the body will look. It is the moment to learn about the patient’s characteristics, evaluate the indication, explain the alternatives, and establish what result can be realistically expected.
Am I a good candidate for this surgery?
This is a question we should ask ourselves together. That a person wants to undergo an intervention does not necessarily mean it is the best option for them at that moment.
The assessment takes into account anatomical characteristics, medical history, and the procedure being considered. It is also important to explain why a particular technique is proposed and whether there are other alternatives. The ASPS includes, within its recommendations, giving priority to this point before making a determination.
For a patient, understanding the indication is as important as knowing the outcome she hopes to obtain. Before deciding, she should be able to understand what is sought to be corrected or improved, what the surgery can contribute, and what its limits are.
What training and experience does the surgeon have?
Choosing the professional is also part of the decision. It is not enough to look at photos of previous results or to know how prominent a doctor is on social networks. It is reasonable to ask about their training, certification, and experience with the procedure that is proposed.
In Argentina, the Buenos Aires Society of Plastic Surgery (SCPBA) establishes among the requirements for full membership that one hold a specialist title awarded by entities recognized by the relevant ministries and have current certification or recertification in plastic surgery. Knowing these credentials does not replace the personal consultation, but provides concrete information before making a decision.
What change do I hope this surgery will bring?
This question deserves an honest conversation. A surgery can modify a specific body feature, but a patient’s expectations can be much broader.
That is why it is important to talk about what you hope to achieve and what you understand as a good result. A photograph of another person can serve as a reference to explain a desire, but it does not allow predicting exactly how the result will appear on another body. Anatomy, tissues, medical history, and individual evolution make every case different.
For these reasons, a good consultation should help define what result is reasonable and also what the limits of the procedure are. A good indication is not only about explaining what a surgery can achieve, but also about clarifying what it cannot guarantee.
What are the risks and how are complications managed?
No surgery is free from risks. Talking about them is not meant to induce fear, but to allow the patient to make a decision with sufficient information. The professional should explain what possible complications are associated with the procedure and how they would be addressed if any occur.
It is also important to discuss those situations that may require a postoperative consultation. A clear explanation helps the patient understand the possible scenarios before deciding.
Where will the surgery take place, who will participate and how will the recovery go?
The place where an intervention is performed is also part of the evaluation. The patient should know where the procedure will take place, who will be in charge of the anesthesia, and how the medical team will be structured. These questions can be overlooked when all attention is focused on the result, but they are indispensable for planning.
Additionally, the postoperative period should be addressed in advance. It is important to know how long the recovery may take, what kind of help the patient might need, when she will be able to progressively resume activities, how follow-ups will be conducted, and whom she should contact if a question arises.
In breast surgery, there are also protocols aimed at systematizing the different stages of this process. This is the ERABAS protocol, Rapid Recovery in breast surgery, which I developed to organize the evolution according to the characteristics of each patient and the procedure performed. Knowing in advance what may occur helps to better organize that period.
Preoperative information, doubts and validation of background
The decision cannot be made without understanding the patient’s particular conditions. Medical history, prior surgeries, allergies, and regular medications are part of the information that must be evaluated during the consultation to determine the necessary studies. That is why it is key to inform the medical team of any relevant data or changes in health status before the intervention.
If doubts still exist, know that a surgical decision does not have to be made in the first appointment. If a patient does not understand the indication, wants to explore another option, or needs time, she can raise it freely or seek a second opinion to gather more information. On the surgeon’s side, there is the responsibility to evaluate the indication, explain the scope, and listen to the expectations without building the decision on a promise of outcome.
Finally, in addition to the medical consultation, it is advisable to turn to institutional sources. Consulting the official page of the Buenos Aires Society of Plastic Surgery — which provides patient information and a Professional Finder — is a recommended step before moving forward.
Plastic surgery is a personal decision that starts long before the operating room. The most important question, then, is not merely “how will I look?”, but “is this surgery a good decision for me?”. Reaching an answer requires time, information, and an open conversation between patient and surgeon.
The author is a plastic surgeon (MN 107.174), the upcoming president of the Buenos Aires Society of Plastic Surgery (SCPBA), and the creator of the ERABAS Rapid Recovery protocol in breast surgery.
